Elevation of the larynx on normal and abnormal cineradiogram

Area of Science:

• Deglutition physiology
• Swallowing disorders
• Oropharyngeal motility

Background:

• Laryngeal elevation is a critical component of safe swallowing.
• Understanding factors influencing laryngeal elevation is crucial for managing dysphagia.
• Pharyngeal dysfunction can compromise airway protection during swallowing.

Purpose of the Study:

• To investigate the impact of bolus volume on laryngeal elevation in non-dysphagic and dysphagic individuals.
• To assess laryngeal elevation in patients with various types of pharyngeal dysfunction.
• To determine the relationship between bolus volume, pharyngeal dysfunction, and swallowing safety.

Main Methods:

• Cineradiography with liquid barium was used to assess 10 non-dysphagic and 10 dysphagic individuals without pharyngeal dysfunction.
• Laryngeal elevation was measured in 60 non-dysphagic and 75 dysphagic patients with different pharyngeal dysfunctions.
• Measurements were taken at the bolus vallecular level and at maximum elevation.

Main Results:

• Laryngeal elevation was not influenced by sex, age, or the presence of dysphagia alone.
• Larger bolus volumes (10 and 20 ml) resulted in lower relative initial laryngeal elevation in dysphagic individuals compared to 2.5 ml.
• Pharyngeal dysfunction was associated with significantly reduced initial laryngeal elevation, particularly in patients with aspiration or laryngeal vestibule closure defects.

Conclusions:

• Bolus volume can influence the efficiency of laryngeal elevation in certain dysphagic populations.
• Pharyngeal dysfunction significantly impairs initial laryngeal elevation, increasing aspiration risk.
• Maximal laryngeal elevation may remain preserved despite initial elevation deficits in pharyngeal dysfunction.